Reviewed by Aaron Horn, LMFT
Bipolar disorder is a lifelong mood disorder that can disrupt nearly every aspect of your life, from moods and attention to energy levels and behaviors. Although there is currently no cure for the disorder, it is possible to treat the symptoms. Without treatment, the mood disorder can be devastating. The frequent manic and depressive episodes that accompany the condition can adversely affect one’s stability and productivity. During depressive episodes, it may be impossible to undertake any activity at all. Early diagnosis and treatment can help prevent these issues. A licensed mental health expert can help with this process and set you on the road to recovery.
The earlier you begin treatment for bipolar disorder, the higher the chances of effective management. However, there is never a bad time to seek treatment options for the condition. The successful treatment of bipolar disorder depends on many factors. It is not enough to use medications. To optimize treatment, patients need to learn about the condition, interact with doctors and therapists, build a reliable support system, and make healthy lifestyle decisions that minimize any dependency on medications. It is vital to adhere to your treatment plan, consulting your doctor as you experience changes in your life.
Maintenance of bipolar disorder will not happen overnight. The condition is chronic, meaning it continues for a lifetime. If the disorder is not treated, depression and mania will return after subsiding. Like the mood swings of the condition, treatments can suffer setbacks. Getting the appropriate treatment may take time. However, with dedication and careful management, you can successfully manage the symptoms and lead a fulfilling life.
Getting started with bipolar disorder treatments
To improve the symptoms, patients need to understand the signs of the condition and themselves. Understanding the effects of bipolar disorder on your behavior will help you differentiate between the signs of the condition from your character. Discuss with a medical professional the behaviors you need help with and then create solid plans to implement the changes.
Your loved ones also need to learn about bipolar disorder. The more information your friends and family have, the better equipped they will be to helping you manage the symptoms, identify triggers, and mitigate crises.
You should be ready to make healthy lifestyle choices. Your recovery journey is about building a healthy lifestyle, which may include physical and social activity, getting adequate sleep, eating well, and avoiding substance use and risky behavior.
Get the treatment that is most effective for you. Discuss the effects of medications, including any unwanted side effects, with your medical professional. Many options are available to try, but it is vital that you discuss these with your doctor before stopping or changing your medications.
Getting the proper diagnosis
A proper diagnosis is the first part of bipolar disorder treatment. It is not always straightforward. The symptoms associated with the condition can be hard to tell apart from other disorders like major depression, ADHD, and borderline personality disorder. For many patients dealing with bipolar disorder, it may take multiple doctor’s appointments before identifying the problem correctly and getting treatment.
Even trained professionals can find diagnosing bipolar disorder a little tricky. Therefore, it is advisable to visit a psychiatrist with experience treating the condition instead of a family doctor or other medical professionals. A psychiatrist is a highly trained mental health professional and knows about recent research and treatment options.
A diagnostic evaluation for bipolar disorder is usually comprised of a:
Psychological evaluation – the doctor or mental health expert will conduct a full psychiatric history. Patients will answer questions about their symptoms, the beginning of the disorder, previous treatments, and a family history of mood disorders.
Medical history and physical – no lab tests are available for diagnosing bipolar disorder, but the doctor may take a medical history and perform a physical exam to eliminate underlying conditions or medications that may be behind the symptoms. Screening for thyroid disorders is especially vital since thyroid issues can result in mood swings that imitate bipolar disorder. Some of the conditions or medications that may imitate the symptoms of bipolar disorder include neurological conditions, antidepressants, corticosteroids, meds for Parkinson’s disease, adrenal disorders, and anti-anxiety drugs.
Together with the psychiatric and medical history, the medical professional may also ask friends and close relatives about the patient’s behaviors and moods. Usually, close friends and family have an objective perspective of the symptoms.
Types of bipolar disorder
There are different types of bipolar disorder. Each type is diagnosed by the nature of manic and depressive episodes. The most appropriate treatment for the condition depends on the type of bipolar disorder. The doctor will observe the patient carefully to determine how the symptoms fit.
Bipolar I disorder (mania and depression): This is the standard nature of the disorder and the most severe form of bipolarity. Patients will often experience at least one manic episode or mixed episode. Most people with bipolar I disorder have also dealt with at least one instance of major depression, although this is not required to receive an official diagnosis.
Bipolar II disorder (hypomania and depression): Mania does not occur in this type. Rather, the condition involves frequent episodes of major depression and a mild form of mania. To get a diagnosis for bipolar II disorder, patients must have suffered at least one hypomanic episode and one major depressive event in their lifetime. If manic disorder occurs, the diagnosis will change to bipolar I disorder.
Cyclothymia (hypomania and mild depression): This is a mild type of bipolar disorder. In this case, patients experience cyclical mood swings, but the highs and lows are not bad enough to fall under mania or major depression. To get a cyclothymia diagnosis, you must have suffered multiple episodes of hypomania and mild depression over a minimum of two years. Since people with cyclothymia are more likely to get a full-blown bipolar disorder, the condition needs to be assessed and treated promptly.
The treatment plan for bipolar disorder
A complete treatment plan for bipolar disorder is designed to alleviate symptoms, restore patients’ ability to function productivity, and correct issues that the disorder has caused at home and work, as well as minimize the occurrence of episodes. Treatment for bipolar disorder often includes:
Medication is the centerpiece of bipolar disorder treatment. Patients with the condition need meds to manage symptoms of the condition. Options include antipsychotics, mood stabilizers, and antidepressants. When used over the long-term, these meds can reduce the recurrence and severity of mood episodes and may even stop them completely. After receiving a diagnosis of bipolar disorder, the doctor will work with the patient to get the most effective drug or combination of drugs. Since everyone reacts to medications differently, you may need to experiment with different medications before identifying one that alleviates your symptoms.
Check in with the healthcare provider regularly. It is necessary to undergo routine blood tests to ensure that the drug levels in your system are in the therapeutic range. Getting the correct dose is an intricate balancing process. Close supervision by the doctor will ensure that the patient stays safe and free of symptoms. Even after stabilizing your mood, do not stop using the medication. Patients are often tempted to stop using their drugs as soon as their symptoms improve. Most people need to take their meds over the long term to prevent relapse.
Note that the medication is not a solution to all of your issues. Bipolar disorder medication can alleviate the symptoms of mania and depression, but to achieve optimal wellness, you need to make healthy lifestyle decisions. These include building a strong support system, undergoing therapy, and resting adequately.
You should be wary of antidepressants. Studies show that antidepressants are not exactly effective in treating bipolar depression. Additionally, they can cause mania or rapid cycling between mania and depression in people with bipolar disorder.
Therapy for bipolar disorder
Research suggests that patients who use medications for bipolar disorder have better chances of successful treatment and quick recovery if they also undergo therapy. Therapy can help you learn to handle the issues caused by the symptoms, including work or relationship problems, as well as self-esteem issues. Therapy is also effective for other issues you might be battling, including anxiety or substance use disorder.
The major types of therapy that are incredibly beneficial for bipolar disorder treatment include cognitive-behavioral therapy (CBT), family-oriented therapy, and individual and social rhythm therapy.
In CBT, patients will understand the role their thoughts play on their emotions. They will also learn ways to transform negative thoughts and behavior into positive ones as a response mechanism. For bipolar disorder, the objective is to manage symptoms, prevent triggers for relapse, and solve problems.
Individual therapy teaches you ways to improve your relationships with the important people around you. Addressing and solving interpersonal issues helps to minimize stress in your life. Considering that stress is a bipolar disorder trigger, this relationship-oriented method can help decrease mood swings.
Social rhythm therapy is usually combined with individual therapy to treat bipolar disorder. The notion is that people dealing with bipolar disorder have extremely sensitive biological clocks – an inner timekeeper that controls circadian rhythms. The clock is easily disrupted by disturbances to your daily routine, also called social rhythms. Social rhythm therapy focuses on stabilizing social rhythms like eating, sleeping, and exercising. After stabilizing these rhythms, the biological rhythm that controls your moods stays stable as well.
Family-oriented therapy is necessary because the condition tends to strain family and marital relationships. It can be difficult to live with someone with bipolar disorder, so the therapy focuses on these issues and tries to restore a healthy and helpful atmosphere at home. Having family members learn about the disease and coping with the symptoms is a major aspect of treatment. Dealing with the issues at home and better communication is also a focus.
Through certain lifestyle choices, people with bipolar disorder can minimize the occurrence of symptoms and mood episodes. These include:
- Avoiding alcohol and drug use
- Keeping a regular sleep schedule
- Minimizing stress
- Eat mood-boosting foods
- Maintain a consistent exercise routine
- Maintain stable exposure to sunlight throughout the year
Good support system
As mentioned earlier, living with bipolar disorder can be difficult, and having a reliable support system can be immensely helpful for changing your motivation and outlook. You can participate in a bipolar disorder support group so that you can get a chance to share your experiences and learn from other people who understand how you feel. Help from friends and family is crucial. Do not feel like you are bothering people who love you – reach out to them.
Inpatient treatment in a facility or a hospital may be helpful if you have a severely unstable mood or start to deal with psychotic or suicidal thoughts or behaviors. Inpatient treatment aims to calm your mood and provide you with required outpatient support to decrease the frequency or duration of future medical appointments.
Most alternative therapies for bipolar disorder are essentially complementary treatments, meaning they should be used along with therapy, medications, and lifestyle changes. Some of the options to consider include:
Mindfulness: Studies have shown that medication and mindfulness-based cognitive therapy can be effective for controlling and preventing anger, depression, agitation, and anxiety. The mindfulness approach includes meditation, breathing exercises, and yoga, all to increase awareness of the current situation and disrupt negative thought patterns.
Acupuncture: Some researchers think acupuncture might be helpful for managing stress response in bipolar patients. Studies on acupuncture for depression have indicated alleviation of symptoms, and there is evidence to suggest that acupuncture may reduce symptoms of mania.
Light and dark therapy: Like social rhythm therapy, light and dark therapy aims to correct the sensitive biological clock of people with bipolar disorder. Light and dark therapy controls the biological rhythm, consequently reducing mood swings through careful regulation of light exposure. The major aspect of the therapy deals with setting an environment of regular darkness by limiting artificial light for 10 hours each night.
The first stage of treating bipolar disorder is getting the right diagnosis. Treatment methods like medications depend on the type of bipolar disorder and if you have a history of substance use disorder. The doctor can make a referral to a psychiatrist, counselor, or other mental health experts so that you can get effective treatment for the mental health condition.
It is also crucial to note that mood symptoms will not disappear forever, so avoid delaying treatment because you have been feeling better. Sometimes, a period of stability is often the best time to build support and get the proper medication to manage future incidents of mania and depression. If you are experiencing mood swings, hallucinations, and delusions, then seek medical help as soon as possible. Bipolar disorder can be treated and moods are manageable. Therefore, do not hold back on getting proper support and treatment for the condition. Take an assessment test on bipolar disorder here.